摘要
目的探讨经导管消融肾交感神经后对心房快速刺激心房颤动（房颤）诱发的影响。方法13只犬分为对照组（7只）和消融组（6只），对照组犬快速心房刺激（800次／min）7h，每小时中断一次监测心房有效不应期（AERP）和房颤诱发；消融组犬先行双侧经皮介入肾动脉消融，后心房快速刺激、AERP监测和房颤诱发同对照组。每组犬在刺激前后均取静脉血检测肾素、血管紧张素Ⅱ（AngⅡ）及醛固酮水平。结果对照组和消融组在心房快速刺激后AERP均明显缩短，两组间无明显差别；快速刺激7h后，对照组房颤诱发平均时间及平均次数均明显高于消融组；对照组的血清肾素和醛固酮水平在快速刺激后明显升高[肾素：（120±31）pg／ml至（185±104）pg／ml，P〈0．01；醛固酮：（288．4±43）pg／ml至（370±110）pg／ml，P=0．01]，AngⅡ呈升高趋势，但差异无统计学意义［（160±48）pg／ml至（189±64）pg／ml，P：0．23]。消融组的血清肾素和醛固酮水平呈下降趋势，差异无统计学意义。结论肾去交感神经可降低短时心房快速刺激房颤的诱发，其可能与肾去交感神经后肾素-血管紧张素-醛固酮系统活性降低有关。
Objective To explore the effects of renal sympathetic denervation on inducibility of atrial fibrillation （AF） during rapid atrial pacing. Methods Thirteen dogs were selected and divided into control group （ n = 7 ） and renal artery ablation group （RAA） （ n = 6）. In the control group, the animals were subjected to atrial pacing at 800 beats/rain for 7 hours. And atrial effective refractory period （AERP） and induced AF were measured hourly during non-pacing. In the RAA group, after each renal artery ablation, the procedures of pacing and electrophysiological measurement were nearly the same as those in the control group. Blood was collected before and after pacing to measure the levels of rennin, angiotensin Ang Ⅱ （Ang Ⅱ ） and aldosterone. Results There was a persistent decrease in AERP in both groups. However, after a 7-hour pacing, induced number of times and duration of AF were higher in the control group than those in the RAA group. The plasma concentrations of rennin and aldosterone increased significantly after 7-hour rapid pacing in the control group （ rennin： （ 120± 31 ） to （ 185± 104 ） pg/ml, P 〈 0. 01, aldosterone： （288 ±43） to （370 ± 110） pg/ml, P =0. 01 ）. No significant difference existed in the levels of Ang H at preand postpacing in the control group （（ 160 ± 48） to （189 ± 164） pg/ml, P = 0. 23）. The levels of rennin and aldosterone showed a decreasing trend in the RAA group. But there was no statistical significance. Conclusions Episodes of AF during shorttime rapid atrial pacing may be decreased by renal sympathetic denervation. This effect is probably related with the decreased activity of RAAS.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第40期2868-2871,共4页
National Medical Journal of China
基金
国家自然科学基金（81070144）
